3a

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Attachment 3a - Spanish
PATH Study Data Collection Instruments:
Household Screener
June 18, 2013

PATH
Household Screener - Spanish
Version 7.5
Number of
questions

Section
Enumeration

13

Tobacco Use

6

Enumeration Check and Sample Selection

2

Relationships and Residential Tenure

5

Contact information -- household respondent

8

Contact information -- sampled person

9

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Version 7.5
Número de control de la OMB: 0925-0664

Fecha de vencimiento: 11/30/2015

Se calcula que el tiempo para esta recolección de información es de 14 minutos por cuestionario,
incluyendo el tiempo necesario para revisar las instrucciones, buscar fuentes de datos existentes, reunir
y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna agencia
puede realizar ni patrocinar una recolección de información, y ninguna persona está obligada a
responder a dicha recolección de información, a menos que esta muestre un número de control vigente
de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta
recolección de información, incluyendo sugerencias de cómo reducir este cálculo de tiempo a: NIH,
Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA
(XXXX-XXXX). No devuelva el cuestionario contestado a esta dirección.

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ENUMERATION
PATH ID:

HM0001

Screen ID:

Voy a hacerle algunas preguntas acerca de las personas que consideran a este domicilio como su
vivienda principal.
Esto incluye a personas que normalmente viven en este domicilio, pero que están fuera temporalmente
por cuestiones de negocios, vacaciones, hospitalizaciones o que viven en un campus universitario.
No incluye a estudiantes universitarios que viven fuera del campus universitario.
Incluyéndose usted, ¿cuántas personas viven en este domicilio y no viven normalmente en otro lugar?
{PROGRAM NOTE: IF RE-ROUTED FROM HM0051, DISPLAY THIS INTERVIEWER INSTRUCTION}
RESPONDENT INDICATED THAT THE ORIGINAL NUMBER OF PEOPLE LIVING AT THIS ADDRESS
WAS WRONG AND NEEDS TO BE CORRECTED: Como usted mencionó que alguien más vive aquí,
necesito confirmar la cantidad de personas que consideran a este domicilio como su vivienda principal.
Usted me dijo que {LIST OF ALL HH MEMBERS} viven aquí, un total de {NUMBER OF PEOPLE}
personas. ¿Cuántas personas viven aquí?
|__|__|__|

NUMBER OF PEOPLE

ASK: All households.
PROGRAM: Start enumeration timing here. The following variables – name, respondent flag, gender, age,
age range, ethnicity, race, military status, twin flag, and the misreported flag (HM0002 – HM0012) – should
appear as a grid. All enumeration information is entered in this grid.
PROGRAM: LIST OF ALL HH MEMBERS – display in Title case. If two names, connect with “y”; if more
than two names, put “y” before the last HH member name. NUMBER OF PEOPLE – fill with total number
of people reported in household.
GO TO: IF RE-ROUTED FROM HM0051, GO TO HM0002[B] AFTER THE NUMBER OF PEOPLE IS
CORRECTED.

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PATH ID:

HM0002

Screen ID:

[A]
¿Cuál es {su primer nombre | el primer nombre de la persona, o de una de las personas, que vive
en este domicilio y que es la propietaria de esta casa o la alquila}?
________________________________________
[PROGRAM NOTE: IF RE-ROUTED FROM HM0051, DISPLAY THIS INTERVIEWER INSTRUCTION
BEFORE QUESITON B]
YOU ARE ADDING HOUSEHOLD MEMBER(S). ASK ALL QUESTIONS ABOUT THE ADDED
HOUSEHOLD MEMBER(S)
[B]

Ahora, dígame por favor únicamente el nombre de los demás miembros de este hogar.

IF TWO HOUSEHOLD MEMBERS HAVE THE SAME FIRST NAME, ASK FOR A MIDDLE INITIAL OR A
SUFFIX (SUCH AS JUNIOR OR SENIOR) TO DISTINGUISH THEM.
______________________________________________________
ASK: All households.
PROGRAM:
If HM0001 = 1 then display “su primer nombre”, else display “el primer nombre de la persona, o de una de
las personas, que vive en este domicilio y que es la propietaria de esta casa o la alquila”.
If HM0001 = 1, do not ask HM0002[B].
The person listed in [A] is the reference person. This variable should appear as the first column on the
nd
grid. For the 1st line on the grid, display text A. For the 2 line, display text B.
PATH ID:

HM0003

Screen ID:

ENTER 1 NEXT TO THE RESPONDENT’S NAME
[IF NOT OBVIOUS, ASK: Gracias por darme los nombres de las personas que viven aquí. Ahora, ¿me
podría dar su nombre, para saber con quién estoy hablando?]
ASK: All households (if needed, as determined by the interviewer).
PROGRAM: This variable should appear as the 2nd column on the grid. Allow only 1 response to this
question.

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PROGRAM: Go through items HM0005 – HM0012 (following appropriate skips), for each household
member. Complete all items for each household member before going to the next household member.
Start with reference person (person A in HM0002) and proceed to additional household members in the
order in which they were reported by the respondent.
When there are no additional household members, go to HM0013.
PATH ID:

HM0005

Screen ID:

¿De qué sexo es {usted/NAME}?
1

MALE

2

FEMALE

-8

DON’T KNOW

-7

REFUSED

ASK: All households about each household member.
PROGRAM: This variable should appear as the third column on the grid. Fill in NAME with the first name
of each household member, in turn from HM0002. For {usted/NAME}, if asking about screener
respondent, display “usted”. Else display “NAME”.
DISPLAY: QxQ #S1 AVAILABLE FOR “sex”.
PATH ID:

HM0006

Screen ID:

¿Qué edad tiene {usted/NAME}?
IF PERSON IS UNDER 1 YEAR, ENTER “0”.
1

|__|__|__|

-8

DON’T KNOW

GO TO HM0008

-7

REFUSED

GO TO HM0008

ASK: All households, about each household member.
PROGRAM: This variable should appear as the fourth column on the grid. For {usted/NAME}, if asking
about screener respondent, display “usted”. Else display “is NAME” and fill with appropriate name in Title
case.
If AGE >= 0 AND AGE < 17 GO TO HM0010, IF AGE >= 17 AND AGE <= 99, GO TO HM0009.
If AGE > 99, GO TO HM0007.

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PATH ID:

HM0007

Screen ID:

Permítame verificar que la edad {suya/de NAME} es {HM0006}. ¿Correcto?
1

SÍ

GO TO HM0009

2

NO

GO TO HM0006

-8

DON’T KNOW

GO TO HM0009

-7

REFUSED

GO TO HM0009

ASK: All households, about each household member whose age was reported as > 99.
PROGRAM: For {suya/de NAME}, if asking about screener respondent, display “suya”. Else display “de
NAME” and fill with appropriate name in Title case.
PATH ID:

HM0008

Screen ID:

Por favor mire esta lista. {Tiene [usted/NAME}…
READ RESPONSE OPTIONS ALOUD.
1

menos de 9 años de edad,

2

entre 9 y 11 años de edad,

3

entre 12 y 17 años de edad,

4

entre 18 y 24 años de edad,

5

entre 25 y 29 años de edad o

6

30 años de edad o más?

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about any household member for whom exact age (HM0006) was DK or R.
PROGRAM: This variable should appear as the fifth column on the grid. For [usted/NAME], if asking
about screener respondent, display “usted”. Else display “NAME”.
DISPLAY: Digital showcard #1.
GO TO: ALL respondents GO TO HM0009, including those that answered DON’T KNOW and REFUSED
to HM0008 and HM0006.

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PATH ID:

HM0009

Screen ID:

¿Actualmente está {usted/NAME} en servicio militar activo en las Fuerzas Armadas, la Reserva o la
Guardia Nacional de Estados Unidos?
[El servicio militar activo para la Reserva o la Guardia Nacional no incluye el entrenamiento regular para
la Reserva o la Guardia. Sí incluye estar activo para misiones militares, como por ejemplo la Guerra de
Iraq.]
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each HH member whose AGE is >= 17 years old OR each HH member where
HM0008 = 4,5,6, DK, R.
PROGRAM: Active duty military (HM0009 = 1) are ineligible for the study. This variable should appear as
the tenth column on the grid. For [usted/NAME], if asking about screener respondent, display “usted”.
Else display “NAME”.
GO TO: If a HH member is active duty military, ask the rest of the demographic section about them, but
do not ask the tobacco use questions.
PATH ID:

HM0010

Screen ID:

¿Es {usted/NAME} hispano(a), [latino I latina I latino o latina] o de origen español?
1

SÍ

2

NO

GO TO HM0011

-8

DON’T KNOW

GO TO HM0011

-7

REFUSED

GO TO HM0011

ASK: All households, about each HH member.
PROGRAM: For {usted/NAME}, if asking about screener respondent, display “usted”. Else display
“NAME”. If male (HM0005 = 1), display “latino”; if female (HM0005 = 2), display latina”; if sex is unknown
(HM0005 = -8 or -7, display “latino o latina”.

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PATH ID:

HM0050

Screen ID:

¿Cuál es el {su origen/ el origen de NAME}? Mire esta lista y escoja todas las opciones que
correspondan.
READ RESPONSE OPTIONS ALOUD.
1

Mexicano, mexicano americano, chicano,

2

puertorriqueño,

3

cubano o

4

de otro origen hispano, latino o español?

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each HH member where HM0010 = 1.
PROGRAM: For {su origen/el origen de NAME}, if asking about screener respondent, display “su origen”.
Else display “el origen de NAME”. If male (HM0005=1), display “chicano” and “latino”; if female
(HM0005=2), display “chicano” and “latino”; if sex is unknown (HM0005 = -8 or -7, display “chicano” and
“latino”.
DISPLAY: If male (HM0005=1), display digital showcard #2M. If female (HM0005=2), display digital
showcard #2F. If sex is unknown (HM0005=-8 or -7), display digital showcard #2O.
PATH ID:

HM0011

Screen ID:

¿Cuál es {su raza/la raza de NAME}? Mire esta lista y escoja todas las opciones que correspondan.
READ RESPONSE OPTIONS ALOUD.
1

Blanca,

2

Negra o africana americana,

3

India americana o nativa de Alaska,

4

Asiática o

5

Nativa de Hawái o de otra isla del Pacífico?

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each HH member.
PROGRAM: For [su raza/la raza de NAME], if asking about screener respondent, display “su raza”. Else
display “la raza de NAME”.
DISPLAY: Digital showcard #3.

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PATH ID:

HM0012

Screen ID:

DO NOT ASK THIS QUESTION.
WAS ANYONE IN THE HOUSEHOLD MISREPORTED AS A HOUSEHOLD MEMBER? LEAVE EMPTY
UNLESS THE RESPONDENT HAS TOLD YOU THAT SOMEONE WAS MISREPORTED. IF
MISREPORTED, ENTER ‘X’.
PRESS ENTER TO CONTINUE.
PROGRAM: This variable should appear as the eleventh column on the grid.
The default for this field is blank – it will only be filled if necessary.
BOX H1
PROGRAM:
If the household has two or more household members with AGE = the same value and AGE is >= 9 and
<= 17, go to HM0014
ELSE, go to BOX H2
PATH ID:

HM0014

Screen ID:

Usted me dijo que hay algunos niños que tienen la misma edad. ¿Son {gemelos | gemelos o nacieron en
otro parto múltiple}?
Incluya a todo tipo de {gemelos I gemelos o nacidos en otro parto múltiple} – ya sean idénticos o no
idénticos, también llamados fraternos.
[Partos múltiples se refieren a gemelos, trillizos, cuatrillizos, etc.]
1

SÍ

GO TO HM0015

2

NO

GO TO BOX H2

-8

DON’T KNOW

-7

REFUSED

ASK: Households where two or more household members have AGE = the same value and AGE is >= 9
and <= 17.
PROGRAM: If there are 2 children who are the same age, fill with “gemelos”. If there are 3 or more
children who are the same age, fill with “gemelos o nacidos en otro parto múltiple”.
DISPLAY: QxQ #S2 AVAILABLE FOR “gemelos”, “parto múltiple”, and “idénticos o no idénticos”.

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PATH ID:

HM0015

Screen ID:

Por favor dígame cuáles niños son {gemelos | gemelos o nacieron en otro parto múltiple}. [Partos
múltiples se refieren a gemelos, trillizos, cuatrillizos, etc.]
ENTER AN X NEXT TO EACH CHILD WHO IS A TWIN OR MULTIPLE BIRTH
IF NEEDED: [Los niños que tienen la misma edad son: {NAME/AGE, NAME/AGE, NAME/AGE…}]
WHEN YOU ARE FINISHED ENTERING ALL THE TWINS/MULTIPLE BIRTHS, ENTER 1 TO
CONTINUE
ASK: About HH twins (HM0014 = 1) whose AGE is >= 9 and <= 17.
PROGRAM: This variable should appear as the twelfth column on the grid. The default for this field is
blank – it will only be filled if necessary. If there are 2 children who are the same age, fill with “gemelos”. If
there are 3 or more children who are the same age, fill with “gemelos o nacidos en un parto múltiple”. Fill
{NAME/AGE} with the names and ages of every child in the household that is the same age.
DISPLAY: QxQ #S2 AVAILABLE FOR “gemelos” and “parto múltiple”.

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El consumo de tabaco
BOX H2

Screen ID:

{PROGRAM: IF THE HOUSEHOLD HAS ONE ADULT}. Las siguientes preguntas son acerca del tabaco.
[Las preguntas acerca de consumo de tabaco no se hacen acerca de los jóvenes menores de 18 años ni
de los adultos que están en servicio militar activo.]
{PROGRAM: IF THE HOUSEHOLD HAS 2 OR MORE ADULTS} These next questions are about tobacco.
Voy a preguntarle acerca del consumo de tabaco de cada uno de los adultos que usted mencionó. [Las
preguntas acerca de consumo de tabaco no se hacen acerca de los jóvenes menores de 18 años ni de
los adultos que están en servicio militar activo.]
PROGRAM: If HM0001=1, use the first phrase. If HM0001>1, use the second phrase.
PATH ID:

HY1003

Screen ID:

Por favor mire esta imagen. ¿Fuma {usted/NAME} ahora cigarrillos, puros o pipa todos los días, algunos
días o nunca?
1

TODOS LOS DÍAS

2

ALGUNOS DÍAS

3

NUNCA

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: For [usted/NAME], if asking about screener respondent, display “usted” ELSE display
“NAME”.
DISPLAY: Digital showcard #4.

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PATH ID:

HS1003

Screen ID:

Por favor mire esta imagen. ¿Consume {usted/NAME} ahora productos de tabaco que no se fuma, como
tabaco de mascar, rapé o dip todos los días, algunos días o nunca?
[No incluya el snus, cigarrillos electrónicos ni productos que contienen nicotina tales como parches,
chicles, inhaladores, aerosoles, pastillas de chupar o píldoras].
1

TODOS LOS DÍAS

2

ALGUNOS DÍAS

3

NUNCA

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: For [usted/NAME], if asking about screener respondent, display “usted” ELSE display
“NAME”.
DISPLAY: Digital showcard #5.
PATH ID:

HE1003

Screen ID:

Ahora, piense en otros productos de tabaco que {usted/NAME} podría haber consumido en algún
momento de su vida.
Por favor mire esta imagen. ¿Ha consumido {usted/ NAME} alguna vez un cigarrillo electrónico como
NJOY, Blu, o Smoking Everywhere, incluso si solo fue una o dos veces?
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: If asking about screener respondent, display “usted” and “usted” ELSE display “NAME” and
“NAME”. For [your/his/her], if asking about screener respondent, display “your” ELSE display “his” if
NAME is male or “her” if NAME is female or “their” if NAME is DK/R.
DISPLAY: Digital showcard #6.

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PATH ID:

HH1002

Screen ID:

Por favor mire esta imagen. ¿Ha fumado {usted/NAME} alguna vez tabaco en una hookah o pipa de
agua, incluso si solo fue una o dos veces?
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: For {usted/NAME} if asking about screener respondent, display “usted” ELSE display
“NAME”.
DISPLAY: Digital showcard #7.
PATH ID:

HU1002

Screen ID:

Por favor mire esta imagen. ¿Ha consumido {usted/NAME} alguna vez snus, incluso si solo fue una o
dos veces?
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: For {usted/NAME} if asking about screener respondent, display “usted”. ELSE display
“NAME”.
DISPLAY: Digital showcard #8.
PATH ID:

HD1002

Screen ID:

Por favor mire esta imagen. ¿Ha consumido {usted/ NAME} alguna vez productos de tabaco que se
disuelve, como por ejemplo Ariva, Stonewall, u Orbs, Sticks o Strips de Camel, incluso si solo fueron una
o dos veces?
[No incluya cigarrillos electrónicos ni productos con nicotina tales como parches, chicles, inhaladores,
aerosoles, pastillas de chupar o píldoras.]
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about each household member AGE>=18 who is not active duty military.
PROGRAM: For {usted/NAME} if asking about screener respondent, display “usted” ELSE display
“NAME”.
DISPLAY: Digital showcard #9.

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ENUMERATION CHECK AND SAMPLE SELECTION
PATH ID:

HM0020

Screen ID:

[Las preguntas acerca de consumo de tabaco que le acabo de hacer, no se hacen acerca de los jóvenes
menores de 18 años ni de los adultos que están en servicio militar activo.]
{Acabo de hacerle preguntas acerca de {NUMBER} miembro(s) del hogar: {LIST ALL HH MEMBERS}.}
Antes de continuar, solo deseo confirmar: ¿hay alguna otra persona que viva en este domicilio?
1

SÍ

GO TO HM0051

2

NO

GO TO BOX H3

PROGRAM: Display “Acabo de hacerle preguntas acerca de {NUMBER} miembro(s) del hogar: {LIST
ALL HH MEMBERS} only if there are two or more HH members. If one member in HH, do not display this
sentence, and only display "Antes de continuar, solo deseo confirmar: ¿hay alguna otra persona que viva
en este domicilio?”
For “{NUMBER}”, display the number of household members collected in the enumeration grid.
For {LIST ALL HH MEMBERS}, display the first name of each household member collected in the grid. If
two HH members, connect names with “y”; if more than two HH members, put “y” before last name in list.
PATH ID:

HM0051

Screen ID:

Las personas que viven en este domicilio lo consideran como su vivienda principal. Esto podría incluir a
personas que están temporalmente fuera en viajes de negocios, vacaciones, hospitalizadas o están en la
universidad.
Para los estudiantes universitarios, incluya a estudiantes que viven en un campus universitario o
fraternidad. No incluye a estudiantes que viven fuera del campus universitario.
La computadora registró que alguien más vive en este domicilio. ¿Es correcto?
1

SÍ

GO TO HM0001

2

NO

GO TO BOX H3

ASK: If HM0020=1

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BOX H3
PROGRAM: DEFINE THE FOLLOWING VARIABLES IN THE SAMPLING ALGORITHM:
SHADOW9TO11
YOUTH12TO17
PH1ADULT
ACTDUTY
SHADOWNUM
YOUTHNUM
ADULTNUM
SHDTWINNUM
YTHTWINNUM
PH1AGE
PH1BLACK
PH1TOBEST
PH1TOBEMG
PH1TOBSTATUS
PH1TOBSTATUS2
PH1PROBSUM
SMPPH1ADLT
PH1PROBADJ
PH1PROB
PH1CUMPROB
SMPPH1ADULT
SMPPH1ADTNUM
ENTER 1 TO CONTINUE. YOU WILL NOT BE ABLE TO GO BACK AND MAKE CHANGES AFTER YOU
CONTINUE PAST THIS POINT.
{PROGRAM: Run the sampling algorithm. Eligibility is determined when the enumeration and tobacco use
identification are completed or screens below SP=Sampled Person. If an SP has been selected, GO TO
HX0014. Else if no household member is selected, end screener and DISPLAY:}
“Gracias por su colaboración el día de hoy. De acuerdo con la información que nos ha dado, su hogar no
ha sido seleccionado para participar en el estudio.”
GO TO DU INCENTIVE WRAPPER
PROGRAM: Set a gate–interviewer CAN NOT GO BACK after sampling algorithm is run.

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PATH ID:

HX0014

Screen ID:

PROGRAM: DISPLAY:
De acuerdo con la información que nos ha dado, hemos seleccionado a{SP FILL 1}, {SP FILL 2}, {SP
FILL 3}, {SP FILL 4}, {SP FILL 5}, {SP FILL 6}, {SP FILL 7}, {SP FILL 8}, y a {SP FILL 9} para participar en
el estudio.
PROGRAM: IF A SHADOW SAMPLE CHILD IS SELECTED, ALSO DISPLAY THE FOLLOWING:
{Además}, {también} quisiéramos hablar con uno de los padres de {APPROPRIATE CHILDREN’S
NAMES} acerca de {invitarlo/invitarla/invitarlos(as)} a participar en el estudio cuando {él/ella/ellos(as)}
{cumpla/cumplan} 12 años.
PROGRAM: IF A SHADOW SAMPLE CHILD IS THE ONLY SP SELECTED IN THE HH, ONLY DISPLAY
THE FOLLOWING:
De acuerdo con la información que nos ha dado, quisiéramos hablar con uno de los padres de
{APPROPRIATE CHILDREN’S NAMES} para {invitarlo/invitarla/invitarlos(as)} a participar en el estudio
cuando {él/ella/ellos(as)} {cumpla/cumplan} 12 años. Nadie más ha sido seleccionado para participar en el
estudio.
ENTER 1 TO CONTINUE
1

CONTINUE

PROGRAM: For each SP selected, NAME / AGE / GENDER. IF SPs and shadow sampled youth are
selected in this household, display words in brackets. If the household respondent is selected, display
them last as “y a usted”

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RELATIONSHIP AND RESIDENTIAL TENURE
BOX H4
IF THERE IS ONLY ONE PERSON IN THE HOUSEHOLD, SKIP HX0020, HX0015, HX0021, HX0018,
GO TO HX0016. Assign ‘01’ IN THE RELATIONSHIP GRID.
PATH ID:

HX0020

Screen ID:

Ahora tengo algunas preguntas acerca de la relación o parentesco entre las personas que han sido
seleccionadas para participar en el estudio.
ENTER 1 TO CONTINUE
1

CONTINUE

ASK: All households where more than one SP was selected.
PATH ID:

HX0015

Screen ID:

¿Cuál es la relación o parentesco {de NAME/suya} con {usted/SP}? En otras palabras,{NAME/usted} es
{la esposa, hermana o hija | el esposo, hermano o hijo} {de usted/de SP}....
1

PERSONA SELECCIONADA (SP)

2

CÓNYUGE

3

PAREJA DE HECHO

4

PROMETIDO(A)

5

NOVIO(A)

6

HIJO(A) (BIOLÓGICO(A), ADOPTIVO(A) O HIJASTRO(A))

7

HIJO(A) ADOPTIVO(A) TEMPORAL (FOSTER)

8

YERNO / NUERA

9

NIETO(A) (BIOLÓGICO(A) O ADOPTIVO(A))

10

HERMANO(A) (BIOLÓGICO(A), ADOPTIVO(A) O HERMANASTRO(A))

11

CUÑADO(A)

12

MADRE / PADRE (BIOLÓGICO(A), ADOPTIVO(A) O PADRASTRO/MADRASTRA)

13

SUEGRO(A)

14

ABUELO(A) (BIOLÓGICO(A) O ADOPTIVO(A))

15

PRIMO(A)

16

TÍO(A)

17

SOBRINO(A)

18

OTRO PARIENTE

19

COMPAÑERO DE VIVIENDA U OTRA PERSONA NO EMPARENTADA

-8

DON’T KNOW

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Household Screener - Spanish
Version 7.5
-7

REFUSED

ASK: All households, about each SP and shadow sampled youth.
PROGRAM:
DISPLAY: QxQ #S3 AVAILABLE FOR ”relación o parentesco”.
Ask HX0015 for each household member reported on enumeration grid in relation to SP #1. Repeat for SP
#2, SP #3, SP #4, SP #5, SP #6, SP #7, SP #8, SP #9 as needed.
For {de NAME/suya}, when collecting information about screener respondent’s relationship to any SP,
display “suya”. Else display name of each household member collected in enumeration grid in “de NAME”.
For {de usted/de SP}, if screener respondent = SP, display “de usted”. Else display SP name in {SP}.
For response options, if HM0005 = 1, then display: 2=Esposo; 3=Pareja de hecho, 4=Prometido, 5=Novio;
6=Hijo (biológico, adoptivo o hijastro); 7= Hijo adoptivo temporal (foster); 8=Yerno; 9=Nieto (biológico o
adoptivo); 10=Hermano (biológico, adoptivo o hermanastro); 11=Cuñado; 12=Padre (biológico, adoptivo o
padrastro); 13=Suegro; 14=Abuelo (biológico o adoptivo); 15=Primo; 16=Tío; 17=Sobrino; 18=Otro
pariente; 19=Compañero de vivienda u otra persona no emparentada.
Else If HM0005 = 2, then display: 2=Esposa; 3=Pareja de hecho, 4=Prometida, 5=Novia; 6=Hija
(biológica, adoptiva o hijastra); 7= Hija adoptiva temporal (foster); 8=Nuera; 9=Nieta (biológica o
adoptiva); 10=Hermana (biológica, adoptiva o hermanastra); 11=Cuñada; 12=Madre (biológica, adoptiva o
madrastra); 13=Suegra; 14=Abuela (biológica o adoptiva); 15=Primo; 16=Tía; 17=Sobrina; 18=Otro
pariente; 19=Compañero de vivienda u otra persona no emparentada.
When collecting information for screener respondent, if screener respondent = SP, assign ‘01’ and go to
next name in relationship grid.
IMPLEMENT THE FOLLOWING LOGIC CHECKS:
AFTER A RESPONSE IS SELECTED, CONFIRM THE RESPOSE BY DISPLAYING THE FOLLOWING:
INTERVIEWER: La computadora ha registrado que {NAME/usted} es el/la [ANSWER] de {SP/usted}?
¿Es correcto? IF THE ANSWER IS NO, ALLOW THE INTERVIEWER TO CORRECT IT.
Check that parental figures and grandparents are at least eleven years older than the SP. IF THE
RESPONSE IS 12, 14, 16, 17 CHECK THAT [NAME’S AGE – SP’S AGE > 10] IF THE CHECK FAILS,
DISPLAY “Usted dijo que [NAME] es el/la [HX0015] de [SP]. ¿Es correcto?” IF THE ANSWER IS NO,
ALLOW INTERVIEWER TO CORRECT IT. DO NOT TRIGGER THIS CHECK A SECOND TIME.
Check that children, grandchildren, nieces and nephews are younger than the SP. IF THE RESPONSE IS
6, 7, 9, 17 CHECK THAT [NAME’S] AGE IS LESS THAN [SP’S] (IN HM0006 AND/OR HM0008). IF THE
CHECK FAILS, DISPLAY “Usted dijo que [NAME] es el/la [HX0015] de [SP]. ¿Es correcto?” IF THE
ANSWER IS NO, ALLOW INTERVIEWER TO CORRECT IT. DO NOT TRIGGER THIS CHECK A
SECOND TIME.
Check that children, grandchildren, nieces and nephews are at least eleven years younger than the SP.
IF THE RESPONSE IS 6, 7, 9, 17 CHECK THAT [SP’S AGE – NAME’S AGE > 10]. IF THE CHECK
FAILS, DISPLAY “Usted dijo que [NAME] es el/la [HX0015] de [SP]. ¿Es correcto?” IF THE ANSWER IS
NO, ALLOW INTERVIEWER TO CORRECT IT. DO NOT TRIGGER THIS CHECK A SECOND TIME.
Check that significant others and SP have no more than a nine year age difference. IF THE RESPONSE
IS 2, 3, 4, 5 CHECK THAT [Maximum of (SP’S AGE, SIGNIFICANT OTHER’S AGE) – Minimum of (SP’S
AGE, SIGNIFICANT OTHER’S AGE) < |10|]. IF THE CHECK FAILS, DISPLAY “Usted dijo que [NAME]
es el/la [HX0015] de [SP]. ¿Es correcto?” IF THE ANSWER IS NO, ALLOW INTERVIEWER TO
CORRECT IT. DO NOT TRIGGER THIS CHECK A SECOND TIME.

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Household Screener - Spanish

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Household Screener - Spanish
Version 7.5
BOX H5
PROGRAM:
All households, in which for any given youth SP or shadow youth, more than 2 parents (father, mother,
step-father, step-mother) are listed in HX0015, GO TO HX0021.
All households, about sampled youth or shadow sampled youth for whom a mother/father or stepmother/step-father was not identified in HX0015, GO TO HX0018.
PATH ID:

HX0021

Screen ID:

La computadora registró que {FILL} son los padres de {SP YOUTH FIRST NAME}. ¿Es correcto?
1

SÍ

GO TO HX0016

2

No. Necesito cambiar mi respuesta

GO TO HX0015

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about sampled youth or shadow sampled youth for whom more than 2 parents
(mother/father or step-mother/step-father) are listed in HX0015.
PROGRAM: For {FILL}, fill with first names of parents identified in HX0015. If two names are listed,
connect with “y”; if more than two are listed, put “y” before last name in list. For {SP YOUTH NAME},
display first name of youth SP from enumeration grid.
PATH ID:

HX0018

Screen ID:

¿Podría decirme quién es el padre, la madre o el tutor de {SP YOUTH NAME}?
{PROGRAM: DISPLAY LIST OF ALL PEOPLE IN HOUSEHOLD EXCEPT [SP YOUTH] ORDERED BY
AGE FROM OLDEST TO YOUNGEST}
PICK PARENT OR GUARDIAN (S) FROM LIST.
94

SP YOUTH IS EMANCIPATED

95

PARENT OR GUARDIAN IS NOT ON THE LIST
INTERVIEWER CLARIFY: _____________________

-8

DON’T KNOW

-7

REFUSED

ASK: All households, about sampled youth or shadow sampled youth for whom a mother/father or stepmother/step-father was not identified in HX0015.
PROGRAM: For {SP YOUTH NAME}, display first name of youth SP from enumeration grid.

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Household Screener - Spanish
Version 7.5
PATH ID:

HX0016

Screen ID:

¿Es usted propietario de la casa o la alquila?
1

HOME IS OWNED BY ANY HOUSEHOLD MEMBER

2

HOME IS RENTED BY ANY HOUSEHOLD MEMBER

3

OTHER

-8

DON’T KNOW

-7

REFUSED

ASK: All households.
PATH ID:

HX0017

Screen ID:

Queremos asegurarnos de que a todos los hogares en esta zona se les ha dado la oportunidad de
participar en este importante estudio. ¿Hay alguna otra persona o grupo de personas de quien no
hayamos hablado y que viva y reciba correspondencia {aquí/en ADDRESS}?
ALSO INCLUDE PEOPLE WHO LIVE HERE AND GET MAIL ONLY AT A P.O. BOX. A YES ANSWER
TO THIS QUESTION WILL LAUNCH THE ADDED HOUSEHOLD PROCEDURE.
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: All households.
PROGRAM: If don’t know house number and/or street name, display “aquí”. Else display “en ADDRESS”
and fill ADDRESS with address.
GO TO: If yes, launch hidden DU procedure at the end of the screener. If no, do not launch the hidden
DU procedure. Do not repeat this question a second time in the launched hidden DU procedure.
BOX H6
Define the following variable: EYOUTH
If (AGE < 18 AND EMANCIPATEDYOUTHDU = 1) Then EYOUTH = 1
If (AGE < 18 AND HX0018 = 94) Then EYOUTH = 1
Else EYOUTH = 2.

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Household Screener - Spanish
Version 7.5

CONTACT INFORMATION
PATH ID:

HL0001

Screen ID:

Quisiera ahora obtener alguna de su información de contacto para mis registros. {También quisiera
solicitarle su ayuda para obtener alguna información básica de contacto para {ADULT SPs} {y} {los}
padres o tutores de {YOUTH SPs}.
ENTER 1 TO CONTINUE
1

CONTINUE

PROGRAM: If there are any adult SPs, fill {ADULT SPs} with the first names of all adult SPs – do not list
the household respondent’s name if he or she is selected as an SP. If youth SPs have been selected,
display “y” followed by the list of youth SP names. If only youth SPs have been selected (and no adult
SPs), omit “y” and display “los” followed by the youth SP names. Separate lists of names with a comma,
and precede the last in the list with “y” as appropriate.
If a single adult household or if the screener respondent is the only SP in the household, do not display
the second sentence.
PATH ID:

HL0002

Screen ID:

¿Podría decirme su nombre completo?
VERIFY ALL SPELLING. IF PERSON HAS NO MIDDLE NAME, LEAVE MIDDLE INITIAL BLANK. IF
NEEDED: [Full name includes first name, middle initial, and last name.]
NAME: ______________________________________________________________
FIRST
MI
LAST
Necesito confirmar su dirección. ¿Es esta dirección correcta?
{PROGRAM: DISPLAY ADDRESS FROM THE SAMPLE FILE IN AN EASY TO READ FORMAT}
READ ADDRESS. VERIFY ALL SPELLING. PROBE FOR APARTMENT NUMBER IF NEEDED. DO
NOT ENTER A PO BOX HERE.
___________________________________________________________________
STREET
APT #
___________________________________________________________________
CITY
STATE
ZIP
-8

DON’T KNOW

-7

REFUSED

ASK: Household respondent about themselves.
PROGRAM: Pre-populate name (first) field based on HM0003. Fill street address, apartment #, city,
state, zip, from sample list. If the first name is don’t know or refused, continue on to ask MI and LAST. If
Street is DON’T KNOW or REFUSED, continue on to ask the rest of the address fields.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0003

Screen ID:

¿Recibe usted el correo en la dirección que me acaba de dar?
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

GO TO HL0005

ASK: Household respondent about themselves.
PATH ID:

HL0004

Screen ID:

¿Me podría dar su dirección postal?
VERIFY ALL SPELLING.
__________________________________________________________________
MAILING ADDRESS
__________________________________________________________________
CITY
STATE
ZIP
ASK: Household respondent about themselves, who don’t get mail at their street address (HL0003 =
2,DK,R).
PROGRAM: If Mailing Address is DON’T KNOW or REFUSED, continue on to ask the rest of the address
fields.
PATH ID:

HL0005

Screen ID:

¿Cuál es el mejor número de teléfono para comunicarse con usted?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
__________
_________________________
_____
AREA CODE
PHONE NUMBER
EXT.
-8

DON’T KNOW

GO TO HL0009

-7

REFUSED

GO TO HL0009

ASK: Household respondent about themselves.
PROGRAM: If the area code is DON’T KNOW or REFUSED, do not ask the rest of the phone number or
the extension.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0006

Screen ID:

¿Es este número de una línea fija en casa o de un celular?
1

LÍNEA FIJA EN CASA

2

CELULAR

3

OTRO

-8

DON’T KNOW

-7

REFUSED

ASK: Household respondent about themselves, who provided a best telephone number in HL0005.
PATH ID:

HL0007

Screen ID:

¿Tiene un número alterno que podamos utilizar para comunicarnos con usted?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
__________
_________________________ _____
AREA CODE
PHONE NUMBER
EXT.
-8

DON’T KNOW

GO TO HL0009

-7

REFUSED

GO TO HL0009

ASK: Household respondent about themselves who provided a best telephone number in HL0005.
PROGRAM: If the area code is DON’T KNOW or REFUSED, do not ask the rest of the phone number or
the extension.
PATH ID:

HL0008

Screen ID:

¿Es este número de una línea fija en casa o de un celular?
1

TELÉFONO FIJO EN CASA

2

CELULAR

3

OTRO

-8

DON’T KNOW

-7

REFUSED

ASK Household respondent about themselves who provided a second telephone number in HL0007.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0016

Screen ID:

¿Me podría dar su correo electrónico?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
_____________________________@________________
E-MAIL ADDRESS
ASK: Household respondent about themselves.
DISPLAY INSTRUCTIONS:
[PROGRAMMING NOTE: FOR SPECIFICATION PURPOSES, THE PERSON FOR WHOM THE CI IS
BEING COLLECTED IS REFERRED TO AS THE “TARGET” IN HL0009 to HL0027.]
PROGRAM:
Full name is collected for all TARGETS. TARGETS are adult SP’s, parents or guardians of youth SP’s
and shadow youth, and youth SP’s and shadow youth.
For [SP ARRAY] create an array that holds the name of each adult SP and youth SP. Do not include the
household respondent. The array should hold the first name provided in (HM0002).
PATH ID:

HL0009

Screen ID:

PROGRAM NOTE: IF ADULT OR YOUTH SPs WERE SELECTED, WITH OR WITHOUT SHADOW
YOUTH, DISPLAY THE FOLLOWING:
Como mencioné, la computadora ha seleccionado a [LIST ALL NAMES IN SP ARRAY | y a usted] para
participar en el estudio.
Quisiera solicitarle su ayuda para obtener alguna información básica de contacto. {Para [YOUTH SPs | y
[SHADOW YOUTH]}, le pediré la información de contacto de uno de los padres o tutores.] [Esta
información se usará únicamente para los objetivos de este estudio.]
PROGRAM NOTE: IF NO ADULT OR YOUTH SPs WERE SELECTED, BUT SHADOW YOUTH WERE
SELECTED, DISPLAY THE FOLLOWING:
La computadora ha seleccionado a [SHADOW YOUTH’S NAME] para participar en el estudio cuando
{él/ella/ellos(as)} {cumpla/cumplan} 12 años. Quisiera solicitarle su ayuda para obtener alguna
información básica de contacto de uno de sus padres o tutores. [Esta información se usará únicamente
para los objetivos de este estudio.]
ENTER 1 TO CONTINUE.
1

CONTINUE

PROGRAM: Display all names, separated by commas, with “y’ before the last name in the array. If the
household respondent is an SP, display all names separated by commas with “y usted”. Include the
sentence in brackets only if there are youth SP’s AND/OR shadow youth. Display their names where
specified.
Ask HL0010 to HL0027 about all targets. Do not ask these questions about the household respondent if
he or she is selected as an SP.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0010

Screen ID:

¿Me podría dar el nombre completo de [TARGET]?
VERIFY ALL SPELLING. [TARGET] IS [FILL] OF [YOUTH SP OR SHADOW YOUTH NAME.] IF
PERSON HAS NO MIDDLE NAME, LEAVE MIDDLE INITIAL BLANK.
NAME: ___________________________________________________________
FIRST
MI
LAST
ASK: Targets are each adult SP AND each parent, step-parent or guardian of a youth SP or shadow
sample youth AND each youth SP AND each shadow sample youth. Ask one time for each target. Do not
ask if target was the household respondent.
PROGRAM: Fill [TARGET] in the question and interviewer instruction with the first name of the target
(HM0002). To select the appropriate parent or guardian target, refer to the relationship matrix (HX0015).
If no parent/step-parent is identified in HX0015 for youth/shadow-youth SP, use response to HX0018.
Fill [FILL] in the interviewer instruction with “SELECTED AS AN ADULT” if the target is an adult SP. Fill
with “IS A PARENT OR GUARDIAN OF” if the target is the parent, step-parent or guardian of a youth SP
or shadow sample youth.
Fill [YOUTH SP OR SHADOW YOUTH NAME] with the SP youth’s or SP shadow youth’s name if the
target is a parent, step-parent or guardian.
If the first name in HL0010 is DON’T KNOW or REFUSED, continue on to ask MI and LAST.
GO TO:
IF TARGET IS YOUTH SP OR SHADOW YOUTH SP, GO TO END.
IF TARGET IS ADULT SP, PARENT, STEP-PARENT OR GUARDIAN OF A YOUTH SP OR SHADOW
YOUTH, CONTINUE TO HL0011.
PATH ID:

HL0011

Screen ID:

¿Cuál es el mejor número telefónico para comunicarse con [TARGET]?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
__________
________________________ ______
AREA CODE
PHONE NUMBER
EXT.
-8

DON’T KNOW

GO TO HL0015

-7

REFUSED

GO TO HL0015

ASK: About each target. Do not ask about household respondent if he or she is selected as an SP. Do
not ask about youth SP’s or shadow youth. Ask one time for each target.
PROGRAM: If the area code is DON’T KNOW or REFUSED, do not ask the rest of the phone number or
the extension.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0012

Screen ID:

¿Es este número de una línea fija en casa o de un celular?
1

TELÉFONO FIJO EN CASA

2

CELULAR

3

OTRO

-8

DON’T KNOW

-7

REFUSED

ASK: About each target for whom a phone number was given. Do not ask about household respondent if
he or she is selected as an SP. Do not ask about youth SP’s or shadow youth. Ask one time for each
target.
PATH ID:

HL0013

Screen ID:

¿Tiene [TARGET] un número de teléfono alterno?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
__________
____________________ __________
AREA CODE
PHONE NUMBER
EXT.
-8

DON’T KNOW

GO TO HL0015

-7

REFUSED

GO TO HL0015

ASK: About each target for whom a phone number was given. Do not ask about household respondent if
he or she is selected as an SP. Do not ask about youth SP’s or shadow youth. Ask one time for each
target.
PROGRAM: If the area code is don’t know or refused, do not ask the rest of the phone number or the
extension.
PATH ID:

HL0014

Screen ID:

¿Es este número de una línea fija en casa o de un celular?
1

TELÉFONO FIJO EN CASA

2

CELULAR

3

OTRO

-8

DON’T KNOW

-7

REFUSED

ASK: About each target for whom a second telephone number was provided in HL0013. Do not ask about
household respondent if he or she is selected as an SP. Do not ask about youth SP’s or shadow youth.
Ask one time for each target.

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Household Screener - Spanish
Version 7.5
PATH ID:

HL0015

Screen ID:

¿Me podría dar el correo electrónico de [TARGET]?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
_____________________________@_______________
E-MAIL ADDRESS
-8

DON’T KNOW

-7

REFUSED

ASK: About each target. Do not ask about household respondent if he or she is selected as an SP. Do
not ask about youth SP’s or shadow youth. Ask one time for each target.
PATH ID:

HM0025

Screen ID:

¿Qué tan bien habla [TARGET] inglés? ¿Diría que lo habla muy bien, bien, no muy bien o nada en
absoluto?
1

Muy bien

GO TO HM0028

2

Bien

GO TO HM0028

3

No muy bien

4

Nada en absoluto

-8

DON’T KNOW

-7

REFUSED

GO TO HM0027

ASK: About each target. Do not ask about household respondent if he or she is selected as an SP. Do
not ask about shadow youth. Ask one time for each target.
PATH ID:

HM0026

Screen ID:

¿Puede [TARGET] hablar inglés lo suficientemente bien como para hacer la entrevista en inglés?
1

SÍ

GO TO HM0028

2

NO

-8

DON’T KNOW

GO TO HM0028

-7

REFUSED

GO TO HM0028

ASK: About each target that does not speak English well (HM0025=3, -8, -7). Do not ask about household
respondent if he or she is selected as an SP. Do not ask about shadow youth. Ask one time for each
target.

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Household Screener - Spanish
Version 7.5
PATH ID:

HM0027

Screen ID:

¿Podrá [TARGET] contestar la entrevista en español?
1

SÍ

2

NO

-8

DON’T KNOW

-7

REFUSED

ASK: About each target that does not speak English well enough (HM0026 = 2) to complete an interview
in English. Do not ask about household respondent if he or she is selected as an SP. Do not ask about
shadow youth. Ask one time for each target.
PATH ID:

HM0028

Screen ID:

{THE SAMPLED YOUTH DOES NOT HAVE A PARENT OR GUARDIAN LIVING IN THE HOUSEHOLD.
THE PARENT INTERVIEW AND YOUTH INTERVIEW WILL NOT BE COLLECTED FOR THIS
SAMPLED YOUTH.}
Gracias por su tiempo y por contestar estas preguntas.
ENTER 1 TO CONTINUE. THIS IS THE END OF THE PHASE 1 SCREENER.
1

CONTINUE

ASK: All households
PROGRAM: IF HX0018=95, display “THE SAMPLED YOUTH DOES NOT HAVE A PARENT OR
GUARDIAN LIVING IN THE HOUSEHOLD. THE PARENT INTERVIEW AND YOUTH INTERVIEW WILL
NOT BE COLLECTED FOR THIS SAMPLED YOUTH.”

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